Hand Therapy for Thumb basal joint arthritis

May 10th, 2007

Prior to any decision to surgically treat thumb basal joint arthritis, conservative treatment may succeed in temporarily decreasing pain. Although this will not cure the disease, it may buy time, and at the very least, may help you to decide if surgery is the necessary next step.

Before Surgery:Conservative Treatment RegimenThenar muscle isometric exercises help to strengthen the muscles around the thumb base, without causing discomfort from having to move the thumb. (see video:Thenar isometric exercises)

Therapy Protocol After Trapezium excision/Ligament reconstruction surgery0-4 weeks: short arm thumb spica cast
4-6 weeks:Plastic forearm-based thumb spica splint made and worn for 4-6 weeks. Thumb IP and MP joint range of motion begins. Basal joint motion also begins--enough to touch the thumb tip to the pointer and middle fingertips. (see video:Range of motion exercises)
6 weeks:Begin thenar isometric exercises (see video:Thenar isometric exercises)
8 weeks:Begin pinch and grip exercises. This may include gentle use of putty to squeeze, and progresses from there.At this time the thumb can begin motion across the palm towards the base of the small finger.